课件：常见震颤的诊断及治疗.ppt

Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs,trunk,eyes,pharynx,larynx,and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or PERIPHERAL NERVE DISEASES. Motor ataxia may be associated with CEREBELLAR DISEASES; CEREBRAL CORTEX diseases; THALAMIC DISEASES; BASAL GANGLIA DISEASES; injury to the RED NUCLEUS; and other conditions. Figure 3 Entrainment of psychogenic tremor. Electrophysiologic surface recording study. A 28-year-old woman had developed tremor in her legs 3 months previously. The surface EMG recordings shown here were recorded with the patient standing. There is nearly simultaneous and rhythmic activity in both anterior tibial muscles, but the length, amplitude, and shape of the single bursts is less regular than in Figure 2. Simultaneous contractions in both limbs (upper row) often indicate voluntary activation. There is only a very slight antagonist activity simultaneous with a reflex-like tonic activity in all muscles. When the patient was asked to slowly tap down her right foot (lower row, black bar), the rhythmic activity almost completely abates (entrainment), suggesting a psychogenic cause for this patient’s tremor. * * 红核冲动传出→下橄榄核→爬行纤维→小脑皮层的浦肯野细胞 下橄榄核的细胞彼此之间由缝隙连接组成同步的神经元集合，在正常情况下产生钙离子介导的规律振荡去极化。这个生理过程在小脑调节精细动作和运动学习中起到重要作用，但也与震颤的产生有关。从某种植物，Harmal plant (Peganum harmala, ‘‘Syrian Rue’’)提取的植物碱能增加下橄榄核神经元的兴奋性，除了有致幻和镇痛作用外也能导致小脑症状如辨距不良、眼震和意向性、姿位性震颤。这个药物可用于制作特发性震颤的动物模型，而破坏了下橄榄核就能使这种震颤停止。 红核冲动传出→下橄榄核→爬行纤维→小脑皮层的浦肯野细胞 下橄榄核的细胞彼此之间由缝隙连接组成同步的神经元集合，在正常情况下产生钙离子介导的规律振荡去极化。这个生理过程在小脑调节精细动作和运动学习中起到重要作用，但也与震颤的产生有关。从某种植物，Harmal plant (Peganum harmala, ‘‘Syrian Rue’’)提取的植物碱能增加下橄榄核神经元的兴奋性，除了有致幻和镇痛作用外也能导致小脑症状如辨距不良、眼震和意向性、姿位性震颤。这个药物可用于制作特发性震颤的动物模型，而破坏了下橄榄核就能使这种震颤停止。 Figure 1 Schematic and simplified synopsis of the brain regions and pathways involved in tremorogenesis. See text for details. (D1, Dopamine receptor type 1; D2